Spinal fusion has classically been the only definitive surgical treatment option for painful discogenic degenerative disc disease in the lumbar spine. Although very effective in some patients, spinal arthrodesis can be associated with several unwanted consequences such as limitations in mobility, pseudoarthrosis and accelerated adjacent level degeneration. Artificial disc replacement (ADR) surgery offers patients a very attractive new option. ADR is a novel technology designed to replace degenerated or injured discs with a prosthesis that allows for normal physiologic movement of the spine, restore disc space height, preserve motion segment flexibility and stability, re-establish the normal lordotic angle, and reduce or eliminate pain from abnormal motion or nerve compression. By preserving normal motion at the level of the surgery, additional stress and load sharing at the adjacent levels is avoided, thus reducing accelerated degeneration to the adjacent levels associated with fusion.
As a Principle Investigation Center for the multiple United States Food and Drug Administration (FDA) studies for artificial disc replacement surgeries, Boulder Neurosurgical & Spine Associates has led the field in clinical testing and evaluating these devices. Boulder Neurosurgical & Spine Associates is also unique in being able to offer multiple different types of artificial disc prostheses, both currently approved by the FDA or undergoing clinical trials. Thus, we are able to select the most suitable artificial disc for the patient based on the clinical symptoms rather than on a select availability of the various implants to a particular surgeon.
BNA neurosurgeons are among a select group of the most experienced arthroplasty surgeons in the nation. It has been widely discussed in the literature that one of the primary reasons for early disappointing reviews involving spinal artificial disc replacement involves poor indications for surgery and inexperience of the surgeon performing the procedure. These are the same reasons why this type of surgery should be trusted to a surgeon who not only has had the required training, but also experience with multiple such devices and implantation techniques. BNA surgeons are very select in only choosing patients with appropriate indications and have achieved very satisfying results for our patients. We feel that this is exactly what makes medicine rewarding.
BNA surgeons and supporting staff are working closely with insurance companies to get the spinal disc replacement procedures approved for our patients. We understand and appreciate how frustrating it is when coverage is denied and to know that sometimes this is the best procedure for a patient. When insurance companies deny approval, we are often able to enroll a patient in an ongoing clinical study and get this procedure paid by the sponsors that support the study.
Lumbar Artificial Discs
Artificial discs are designed to replace a damaged intervertebral disc. As the name implies, artificial discs are similar to normal human discs in the neck and low back.
Total disc replacement surgery is considered an alternative to spinal fusion in select patients. Spinal fusion fuses and permanently joins two (or more) vertebral bodies and eliminates movement at that level. An artificial disc works differently – it allows movement by mimicking the properties of a human disc. In theory, disc replacement protects other discs by sharing the stress during movement.
There are many different artificial disc designs. Implant composition includes hard and soft materials.
- Hard: metal, such as stainless steel
- Soft: nonmetal, such as polyethylene
Charité® Lumbar Artificial Disc. Model of the disc and x-rays; anterior-posterior and lateral views.
ProDisc-L Artificial Disc. Model of the device and x-rays; flexion / extension views.
Since artificial discs are not indicated to treat all spinal disorders or patients, evaluation by a spinal surgeon skilled in the use of artificial discs is essential. If an artificial disc is a good choice for you, your neurosurgeon will explain the type of device to be implanted. Along with information about the artificial disc, you will learn about the benefits and risks of the device and procedure.
Surgeons at Boulder Neurosurgical & Spine Associates (BNA) use the latest spine technologies and believe artificial discs benefit carefully selected patients. If you have questions, please talk to your surgeon to find out if disc replacement is appropriate to treat your spinal disorder.